The WHO’s physical activity guidelines (2020) for adults: 150 to 300 minutes per week of moderate-intensity endurance activity, or 75 to 150 minutes of vigorous intensity, plus muscle strengthening twice a week. After 65, balance is added. In France: at least 30 minutes of brisk activity per day, and breaking up sitting time every two hours.
What are the physical activity guidelines for adults?
For adults aged 18 to 64, the World Health Organization recommends, in its guidelines of November 25, 2020, at least 150 to 300 minutes per week of moderate-intensity endurance activity, or 75 to 150 minutes of vigorous intensity, or a combination of both, as well as muscle-strengthening activities at least two days a week. These benchmarks apply to all adults, including people living with a chronic disease or a disability, the WHO specifies.
How can you tell the intensity? The simplest criterion is the one used by Manger Bouger (“Eat, Move,” the official public health nutrition and physical activity website run by Santé publique France, the French public health agency): at moderate intensity, you can still hold a conversation; at vigorous intensity, talking becomes difficult and you sweat noticeably. Brisk walking, cycling on flat ground, leisurely swimming and vigorous gardening are moderate; running, cycling uphill and team sports are vigorous.
In France, the National Nutrition and Health Program (Programme national nutrition santé, PNNS), whose guidelines were updated by Santé publique France on January 22, 2019, translates these recommendations into a daily message: at least 30 minutes of brisk physical activity per day, plus, twice a week, activities for muscle strength, flexibility and balance. Thirty minutes a day, five to seven days a week, falls squarely within the 150 to 300 weekly minutes.
| Benchmark | Adults aged 18 to 64 | Adults aged 65 and over |
|---|---|---|
| Endurance (heart and lungs) | 150 to 300 min per week of moderate intensity, or 75 to 150 min of vigorous intensity (WHO 2020, Ameli) | At least 150 min per week of moderate intensity, or 75 min of vigorous intensity, adapted to abilities (Ameli) |
| Muscle strengthening | At least twice a week (WHO, Ameli) | At least 2 non-consecutive days per week (Ameli) |
| Flexibility | 2 to 3 times a week (Ameli) | At least 10 minutes, at least twice a week (Ameli) |
| Balance | Twice a week, together with strengthening and flexibility (Manger Bouger) | At least twice a week: cycling, dancing, yoga (Ameli); a WHO priority after 65 |
| Sedentary time | Less than 7 hours sitting per day; a 5- to 10-minute break every 2 hours (Ameli, Manger Bouger) | Same, with particular attention to hydration (Ameli) |
| PNNS daily benchmark | At least 30 minutes of brisk activity per day | Same, adapted to how you feel that day |
What is recommended after 65?
The same foundations, with two additional priorities: strength and balance. The WHO asks people aged 65 and over to add activities that work on balance and coordination as well as muscle strengthening, because these are what protect against falls and loss of independence. French National Health Insurance (Assurance Maladie) gives the details: endurance activity of at least 150 minutes per week at moderate intensity, muscle strengthening on at least two non-consecutive days, flexibility for at least ten minutes twice a week, and balance at least twice a week.
Two points that matter in practice. First, adaptation: intensity is set according to how you feel that day, and returning to activity after a long break or an illness should be discussed with your regular doctor (médecin traitant). Second, hydration: after 65, the sensation of thirst becomes dulled, and you need to drink before, during and after exercise even if you are not thirsty, French National Health Insurance points out.
These are the ages at which the prevention check-up is most useful on this topic: at 60–65, to build the habit before or around retirement, and at 70–75, to prevent falls and loss of muscle mass. We detail these two appointments in the prevention check-up at ages 60–65 and the prevention check-up at ages 70–75.
Is sedentary behavior the same as lack of physical activity?
No, and this is the most common confusion. The WHO defines sedentary behavior as any period of low energy expenditure while awake: time spent sitting, reclining or lying down, at a desk, in a car, in front of a screen. You can run for an hour on Sunday and remain sedentary six days out of seven, eight hours a day. The two behaviors are distinct risk factors, and their effects add up.
The French benchmarks are concrete: spend less than 7 hours a day sitting between getting up and going to bed, and break up periods of sitting with a 5- to 10-minute break every 2 hours, walking for a few minutes and stretching, according to French National Health Insurance and Manger Bouger. This is not a minor detail: for an adult with a desk job, these breaks are often the most accessible lever, well before signing up at a gym or club.
Worldwide, 31% of adults do not reach recommended levels of physical activity, according to the WHO (2022 data), and physical inactivity is, along with tobacco, an unhealthy diet and alcohol, one of the behavioral risk factors for cardiovascular disease. French National Health Insurance also uses the threshold of less than 30 minutes of physical activity per day as a risk factor for type 2 diabetes, in the same way as excess weight or family history.
What does the prevention check-up identify about physical activity?
The prevention check-up is a 30- to 45-minute consultation, fully covered (100%) by French National Health Insurance, offered at ages 18–25, 45–50, 60–65 and 70–75. Physical activity and sedentary behavior are among its official themes, and the self-assessment questionnaire asks the two questions we ask in consultation: how much time do you spend moving, and how much time do you spend sitting? The general framework of the program is described on our page about the prevention check-up.
In our experience, what the check-up identifies first is the gap between perception and reality. “I move a lot” often means low-intensity household activity; “I do sports” sometimes means one weekly session lost in fifty hours of sitting. The questionnaire puts numbers on it, and the numbers speak for themselves. It then identifies barriers: joint pain, shortness of breath, fear of falling, lack of time, no suitable place. And it identifies situations where physical activity should be medically supervised: known cardiovascular disease, diabetes, obesity, COPD, ongoing cancer treatment.
What comes out of it is a Personalized Prevention Plan with a realistic goal (“walk 20 minutes after lunch four days a week” rather than “do sports”) and, when justified, a referral to your regular doctor for a prescription of adapted physical activity. The plan is sent to your regular doctor unless you object. Between 45 and 50, physical activity is almost always one of the two levers we choose when 10-year cardiovascular risk starts to rise, often together with quitting smoking.
Adapted physical activity on prescription: for whom, by whom, at what cost?
Adapted physical activity (activité physique adaptée, APA) is activity supervised by a trained professional, designed for people whose health limits ordinary exercise. Since the law of March 2, 2022, the doctor involved in a patient’s care can prescribe it for people with a long-term condition (affection de longue durée) or a chronic disease, with risk factors, or experiencing loss of independence, French National Health Insurance specifies. The prescription can be renewed once by a physiotherapist.
Who provides it? Physiotherapists, occupational therapists and psychomotor therapists, qualified APA instructors (holding a STAPS bachelor’s degree in sport sciences with an “adapted physical activity and health” specialization), and sports instructors or people certified by approved federations, subject to qualification requirements. The usual format: two to three sessions of 45 to 60 minutes per week, over three months, possibly renewable. The French National Authority for Health (HAS) has published a guide to consultation and prescription (2018, updated in 2022) with reference frameworks for specific situations: high blood pressure, heart failure, type 2 diabetes, COPD, breast, colorectal and prostate cancers, depression, overweight and obesity, older adults, pregnancy and postpartum.
The point that often disappoints: these sessions are not reimbursed by French National Health Insurance, even with a prescription. They may be covered by some supplementary health insurers (mutuelles) and some local authorities, and Maisons Sport-Santé (sport-for-health centers), listed on the interactive map of the French ministry responsible for sports, direct people to local programs, some of them free. The prevention check-up is the right time to find out what is available near you: the Santé.fr map (France’s official public health information website) also lists adapted physical activity programs. Physiotherapists are also expected to be able to carry out the prevention check-up themselves starting in October 2026.
How do you get started if you have never done any sport?
With activity, not sport. Most of our patients who have “never done any sport” walk, climb stairs or garden: the starting point already exists. Here is the progression we suggest at the check-up.
- Measure an ordinary week. Your phone’s pedometer is enough. No judgment, just observation.
- Add ten minutes of brisk walking per day, at a set time: your commute, lunch break, after dinner. Ten minutes is not much, but it is a step that counts: every move counts, says the WHO.
- Break up sitting time: get up every 2 hours, take calls standing up, get off one stop earlier.
- Move up to 30 minutes, in one or two sessions, after three to four weeks, then add two short strengthening sessions (getting up from a chair without using your hands, climbing stairs, carrying groceries) and, after 65, balance sessions.
- Choose an activity you enjoy and can do with someone else: regularity depends on that more than on performance.
When should you get medical advice first? If you have known cardiovascular disease, diabetes, chest pain or unusual shortness of breath during exertion, are currently undergoing treatment, or are resuming activity after 65 following a long break: your regular doctor will make adjustments and can prescribe adapted physical activity. Diet and physical activity reinforce each other; we address them together at the check-up, along with the other modifiable factors.
Key takeaways
- WHO 2020, adults: 150 to 300 minutes per week of moderate endurance activity, or 75 to 150 minutes of vigorous activity, plus muscle strengthening twice a week; PNNS benchmark: 30 minutes of brisk activity per day.
- After 65: the same foundations, adapted, plus strengthening on two non-consecutive days and balance at least twice a week.
- Sedentary behavior and inactivity are two distinct risks: aim for less than 7 hours of sitting per day and a break every 2 hours.
- Adapted physical activity can be prescribed since the law of March 2, 2022, but is not reimbursed by French National Health Insurance; mutuelles, local authorities and Maisons Sport-Santé can help.
- The prevention check-up puts numbers on the gap between perception and reality and sets a realistic goal, which is sent to your regular doctor.
What Sokrate lets you do
Sokrate lets you prepare your prevention check-up online: an adaptive questionnaire covering nine dimensions of health, including physical activity, sedentary behavior, diet and cardiovascular risk, followed by a personalized plan written and signed by a doctor and sent to your regular doctor, unless you object. A care coordination nurse provides long-term follow-up, for as long as it takes for a habit to settle in. The check-up remains fully covered (100%) by French National Health Insurance when carried out by an authorized professional. To be notified when the service opens in your region, join the waitlist.